Every so often, I catch myself wondering, what if I had applied to medical school just two years later?

As another class of medical students matriculates, that question has become harder to ignore.

On July 1, changes made to federal student loan programs under the One Big Beautiful Bill went into effect. These changes cap how much graduate students can borrow and eliminate the current Graduate PLUS loan structure that has allowed many medical students to cover the full cost of attendance.

I am a current medical student and was fortunate to be grandfathered into the existing federal Graduate PLUS loan program. Because I enrolled before recent changes, I will be able to complete my medical education with access to the financing that made it possible for me to attend in the first place.

Without Graduate PLUS loans, I simply could not have afforded medical school.

Like many students, I come from a family that believed in my dream of becoming a physician but could not finance four years of tuition and living expenses that often total hundreds of thousands of dollars. Medical school is unlike nearly every other graduate program. The demands of coursework and clinical training leave little opportunity for meaningful outside employment, and private loans often require strong credit histories, co-signers, or financial resources that many applicants do not have.

Graduate PLUS loans allowed me to pursue medicine because of my work ethic and commitment to serving others, not because of my family’s financial circumstances.

My story is far from unique.

Many of my classmates are here for the same reason. Some are first-generation college students. Others come from middle-income families that earn too much to qualify for significant financial aid but nowhere near enough to pay for medical school out of pocket. We all arrived through different paths, but we share one reality: Federal student loans made medical school possible.

According to the Association of American Medical Colleges (AAMC), approximately 70% of graduating medical students leave school with educational debt, with a median debt of about $215,000 among borrowers. For most future physicians, borrowing is not the exception. It is the norm.

I plan to pursue primary care because I believe every patient deserves access to continuous, preventive, and compassionate health care. America already faces a growing physician shortage. The AAMC projects the nation could face a shortage of up to 86,000 physicians by 2036. Nearly 1 in 5 Americans live in a rural community, but only 1 in 10 physicians practice there, according to the National Rural Health Association. Across the country, patients already wait months for appointments, travel hours to see specialists, or struggle to find a primary care physician accepting new patients.

At the moment we need more physicians, we are considering policies that could make becoming one less attainable.

Supporters of graduate loan caps argue that they reduce federal spending and encourage schools to control tuition. These are reasonable goals. Medical education is expensive, and the cost structure deserves scrutiny.

But limiting access to financing without reducing the cost of attendance does not make medical school more affordable. It simply changes who is able to attend.

Research consistently shows that physicians from rural, lower-income, and historically underserved backgrounds are more likely to return to those communities to practice. Those are the very communities already facing some of the nation’s greatest physician shortages. When financial barriers discourage these students from entering medicine, patients in underserved communities ultimately pay the price.

What concerns me just as much is the uncertainty students are already experiencing. As schools adjust to changes in federal lending policy, applicants are facing questions about borrowing limits, financial aid timelines, and whether they will be able to afford enrollment. For many, that uncertainty is not just stressful. It can determine whether they enter medical school at all.

I have been spared much of that uncertainty because I was grandfathered into the previous system. Even so, I often wonder how different my path might have been if I had applied just a couple of years later.

Would I still be in medical school?

Or would the cost be too high to overcome?

These are no longer hypothetical questions for the next generation of applicants.

Congress has an opportunity to address the rising cost of medical education through meaningful reform. Expanding need-based scholarships, strengthening service-based repayment programs, investing in graduate medical education, and increasing transparency around tuition all address the underlying problem. Restricting access to federal financing does not.

Every time I put on my white coat, I am reminded that I am here because a federal loan program made it possible for me to pursue medicine despite financial barriers. I worry that many students who come after me will not have this opportunity.

Gauri Gurumurthy is a third-year medical student. She is interested in primary care and health care access. She writes on issues related to medical education, the physician workforce, and health policy.